• Title/Summary/Keyword: 기형발생

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A Clinical Study of Hypertrophic Pyloric Stenosis (비후성 유문 협착증의 임상적 고찰)

  • Kim, Yoon Hee;Jung, Myung Sup;Byun, Soon Ok
    • Clinical and Experimental Pediatrics
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    • v.45 no.11
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    • pp.1389-1396
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    • 2002
  • Purpose : This study was done to analyze the changes in the clinical conditions and the diagnosis of hypertrophic pyloric stenosis. Methods : We report a retrospective clinical analysis of 39 patients with hypertrophic pyloric stenosis from Jan. 1992 to Aug. 2001. The age and sex distribution, family and birth history, clinical symptoms, the ultrasonographic and the operative sizes of pyloric canals were compared. Results : The body weight was below the 3 percentile at admission in eight cases(20.5%). "Olive like mass" in right upper quadrant was palpated during physical examination in 23 cases(59%) and gastric peristaltic wave observed in six cases(15%). The ultrasonographic measurements showed that the pyloric muscle thickness to be $4.95{\pm}0.99mm$($mean{\pm}SD$), pyloric diameter $14.42{\pm}2.64mm$, and pyloric length $20.17{\pm}3.92mm$. Fredet-Ramstedt pyloromyotomy was employed in all cases. The operative measurements of the pyloric muscle thickness was $5.11{\pm}1.01mm$, pyloric diameter $15.01{\pm}2.47mm$, and pyloric length $22.32{\pm}3.43mm$. Conclusion : There was no significant difference between the ultrasonographic and operative measurements. Currently, the hypertrophic pyloric stenosis patients showed lesser clinical hallmarks of the disease. The earlier diagnosis using imaging studies before development of significant metabolic abnormalities is becoming an important factor that change the future outcomes of hypertrophic pyloric stenosis.

Clinical features of congenital muscular torticollis (선천성 근성 사경의 임상적 특징)

  • Jun, Ji Eun;Ryu, Hye Kyeong;Shim, Jae Won;Shim, Jung Yeon;Jung, Hye Lim;Park, Moon Soo;Kim, Deok-Soo
    • Clinical and Experimental Pediatrics
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    • v.50 no.3
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    • pp.241-247
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    • 2007
  • Purpose : Congenital muscular torticollis (CMT) is a common and benign congenital disorder of the musculoskeletal system in neonates and infants. The pathophysiology is that the sternocleidomastoid muscle (SCM) is shortened on the involved side by fibrosis, leading to ipsilateral tilt and contralateral rotation of the face and chin. In this study, we investigated the clinical features of CMT, the role of ultrasonography (USG) in prediction of prognoses and the clinical significance of early detection and treatment. Methods : Forty seven patients (M:F=31:16) were diagnosed as a CMT between March 2003 and May 2006. We reviewed age at diagnosis, physical findings, USG findings, treatment and therapeutic outcome from their medical records. Results : The median age at diagnosis was 90 days (18 days-9 years, 7 months) and the right side of neck was affected in more patients (right : left=26:21). Of 24 patients with a palpable neck mass, 21 had USG; 19 cases showed sternocleidomastoid tumor (SMT). In cases with no neck mass, USG was performed in 11 patients; seven had postural torticollis (POST), three had SMT and one had muscular torticollis (MT). Among 40 patients with follow-up, 36 had total resolution. There was negative correlation between the age at diagnosis and the recovery time, whereas the final outcome was not correlated with USG findings. However, the patients without positive findings in USG had earlier resolution (1 month vs 2.6 months, P=0.0008). The patients with SMT had earlier diagnosis and excellent outcomes. The patients with MT were delayed to diagnosis and had the longest time to resolve. Lastly, the patients with POST had delayed diagnoses, but they had excellent outcomes. Conclusion : Since the patients with delayed diagnoses, in despite of benign courses, may take a long time to resolve and rarely need surgical treatment, it is important to diagnose and treat early. This study showed that USG findings of the SCM may be used as predictive factors.

Urine endothelin-1 as a Biomarker for Urinary Tract Infections in Children (Urine endothelin-1의 소아 요로 감염 환아에서의 진단적 유용성)

  • Kee, Hyung Min;Yi, Dae Yong;Yun, Ki Wook;Lim, In Seok;Ha, Tae-Seon
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.36-41
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    • 2014
  • Purpose: Urinary tract infections (UTIs) are the most common source of bacterial infections in infants and young children. Accurate diagnosis and treatment is important because of their association with renal scarring, which can lead to complications. Urine endothelin-1 (ET-1) is the major renal isoform produced and released by renal mesangial cells in response to glomerular injury. This study aimed to investigate whether urinary levels of ET-1 can be used as a biomarker for UTI diagnosis. Method: We conducted a prospective study using medical records of 70 patients below the age of 18 years, who visited Chung-Ang University Hospital from July 2012 to July 2013. We classified the patients into the UTI and control groups based on urine culture studies. The UTI group was further divided into upper and lower UTI groups using 99m-Technetium dimercaptosuccinic acid scintigraphy. Urine ET-1 was measured using enzyme linked immunosorbent assay with 0.3 mL urine. Results: The UTI and control groups were comprised of 45 and 25 patients, respectively. Mean urine ET-1 levels were significantly higher in the UTI group than in the control group ($1.41{\pm}0.35$ pg/mL vs. $0.33{\pm}0.07$ pg/mL, P =0.04). There was no significance difference in the quantitative value between the upper and lower UTI groups (P =0.552). There was no correlation between urine ET-1 and serum C-reactive protein (Pearson correlation [R]=0.24), urine ET-1 and serum white blood cell count (R=0.19). Conclusion: Our study suggests that urine ET-1 can be used for early diagnosis of UTI in children.

Improvement of Fontan Circulatory Failure after Conversion to Total Cavopulmonary Connection (완전 대정맥-폐동맥 연결수술로 전환 후의 폰탄순환장애 개선)

  • Han Ki Park;Gijong Yi;Suk Won Song;Sak Lee;Bum Koo Cho;Young hwan Park
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.559-565
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    • 2003
  • By improving the flow pattern in Fontan circuit, total cavopulmonary connection (TCPC) could result in a better outcome than atriopulmonary connection Fontan operation. For the patients with impaired hemodynamics after atriopulmonary Fontan connection, conversion to TCPC can be expected to bring hemodynamic and functional improvement. We studied the results of the revision of the previous Fontan connection to TCPC in patients with failed Fontan circulation. Material and method: From October1979 to June 2002, eight patients who had failed Fontan circulation, underwent revision of previous Fontan operation to TCPC at Yonsei University Hospital. Intracardiac anomalies of the patients were tricuspid atresia (n=4) and other functional single ventricles (n=4). Mean age at TCPC conversion was 14.0$\pm$7.0 years (range, 4.6~26.2 years) and median interval between initial Fontan operation and TCPC was 7.5 years (range, 2.4~14.3 years). All patients had various degree of symptoms and signs of right heart failure. NYHA functional class was 111 or IV in six patients. Paroxysmal atrial fibrillation (n:f), cyanosis (n=2), intraatrial thrombi (n=2), and protein losing enteropathy (PLE) (n=3) were also combined. The previous Fontan operation was revised to extracardiac conduit placement (n=7) and intraatrial lateral tunnel (n=1). Result: There was no operative death. Major morbidities included deep sternal infection (n=1), prolonged pleural effusion over two weeks (n=1), and temporary junctional lachyarrhythrnia (n=1). Postoperative central venous Pressure was lower than the preoperative value (17.9$\pm$3.5 vs. 14.9$\pm$1.0, p=0.049). Follow-up was complete in all patients and extended to 50,1 months (mean, 30.3$\pm$ 12.8 months). There was no late death. All patients were in NYHA class 1 or 11. Paroxysmal supraventricular tachycardia developed in a patient who underwent conversion to intraatrial lateral tunnel procedure, PLE was recurred in two patients among three patients who had had PLE before the convertsion. There was no newly developed PLE. Conclusion: Hemodynamic and functional improvement could be expected for the patients with Fontan circulatory failure after atriopulmonary connection by revision of their previous circulation to TCPC. The conversion could be performed with low risk of morbidity and mortality.

TOOTH MOVEMENTS TO THE SITE OF ALVEOLAR BONE GRAFT (구순구개열 환아에서의 치조골이식)

  • Cho, Hae-Sung;Park, Jae-Hong;Kim, Gwang-Chul;Choi, Seong-Chul;Lee, Keung-Ho;Choi, Yeung-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.1
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    • pp.140-149
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    • 2007
  • Cleft lip and palate are congenital craniofacial malformation. Reconstruction of dental arch in patient with alveolo-palatal clefts is very important, because they have many problems in functions and esthetics. Malnutrition, poor oral hygiene, respiratory infections, speech malfunctions, maxillofacial deformity, and psychological problems may be occured without proper treatment during the long period of management of the cleft lip and palate. So the treatment should be managed with a multidisciplinary approach. Bone grafting is a consequential step in the dental rehabilitation of the cleft lip and palate patient A complete alveolar arch should be achieyed of the teeth to erupt in and to form a stable dentition. And the presence of the cleft complicate the orthodontic treatment. Therefore bone grafting in patients with cleft lip and palate is a widely adopted surgical procedure. Grafted bone stabilizes the alveolar process and allows the canine or incisor to move into the graft site. After the bone grafting, orthodontic closure of the maxillary arch has become a common practice for achieving dental reconstruction without any prosthodontic treatment. Various grafting materials have been used in alveolar clefts. Iliac bone is most widely fovoured, but tibia, rib, cranial bone, mandible have also been used. And according to its time of occurrence, the bone graft may be divided into primary, early secondary, secondary, late secondary. Bone grafting is called secondary when performed later, at the end of the mixed dentition. It is the most accepted procedure and has become part of treatment of protocol A secondary bone graft is performed preferably before the eruption of the permanent canine in order to provide adequate periodontal support for the eruption and preservation of the teeth adjacent to the cleft. In this report, we report here on a patient with unilateral cleft lip and palate, who underwent iliac bone graft. The cleft was fully obliterated by grafted bone in the region of the alveolar process. The presence of bone permitted physiologic tooth movement and the orthodontic movement of adjacent tooth into the former cleft area. Satisfactory arch alignment could be achieved in by subsequent orthodontic treatment.

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The Petrographic Investigation of Soda Straws in Baeg-nyong Cave, Pyeongchang-gun, Gangwon-do, South Korea (강원도 평창군 백룡동굴에서 산출되는 종유관의 기재학적 연구)

  • Cho, Jae-nam;Jo, Kyoung-nam
    • Journal of the Korean earth science society
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    • v.38 no.1
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    • pp.64-79
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    • 2017
  • We have reported the petrographic properties on the soda straw primarily based on the field measurements and discussed the causes of their traits. 156 soda straws in district B of the Baeg-nyong Cave nominated with the natural monument No. 260 have been investigated to estimate physical, sedimentological and textural characteristics. The soda straws have an average length of 3.05 cm with a standard deviation of 1.7 cm and a mean diameter of 6.0 mm. This result shows that the average diameter of the soda straws measured in this study is thicker than previous reports by 20%. Although the drip rates of cave water from 85.3% of all the soda straws are exceedingly lower than 1 drop per 10 minutes, almost all soda straws have a dripping water. We firstly report growth lamina in the Korean soda straw from 85.3% of all samples, and this textural dominance indicates that the growth lamina are one of the common features of the soda straws at least in the study area. Secondary precipitations inside the soda straw were identified from 68.6%. Notably, the strong inverse correlation between growth lamina and secondary precipitates was represented from 70.5% of all samples. This finding might be explained by the seasonality of cave drip water supplied into the soda straws or the increased opacity caused by secondary precipitates. Based on petrograhic characteristics, the soda straws in the study area can be classified into normal and erratic types. Hopefully our results on the soda straws in Baeg-nyong Cave would provide a basis for the descriptions of soda straws from other caves and paleoclimatic applications.

The Clinical Applicability of Transoral Transpharyngeal Approach to the Craniovertebral Junction Lesions (두개 경추 이행부의 병소에 대한 경구적 접근법의 유용성)

  • Cho, Tae Goo;Park, Kwan;Cho, Yang-Sun;Baek, Chung-Hwan;Nam, Do Hyun;Kim, Jong Soo;Hong, Seung-Chyul;Shin, Hyung Jin;Eoh, Whan;Kim, Jong Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.379-388
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    • 2000
  • Objective : Although transoral transpharyngeal approach is a very useful method for the lesions of craniovertebral junction, it is not frequently used because of anatomical unfamilarity, risk of cerebrospinal fluid(CSF) leakage, and resultant postoperative meningitis. To evaluate the usefulness of transoral transpharyngeal approach for various lesions of craniovertebral junction, clinical characteristics and the results of this approach are investigated. Methods : Transoral transpharyngeal approaches were performed in eight cases between 1996 and 1999. Among them, there were three basilar invaginations due to congenital anomalies, two odontoid type I fractures, two atlantoaxial dislocations, and one pseudotumor. Surgical methods included five cases of anterior decompression and posterior fusion, two anterior approaches for decompression and one transoral approach for biopsy. Results : This procedure allowed immediate clinical improvement in all cases. In seven patients with preoperative motor deficit showed a progressive neurological improvement. The follow-up plain x-rays demonstrated successful bony fusion in all patients. Only one patient suffered from postoperative wound dehiscence, but she completely recovered after wound revision. There was no complication of postoperative CSF leakages. Conclusions : Transoral transpharyngeal approach for the ventral lesions of craniovertebral junction, can be used as a relatively simple and effective method.

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Characteristics and Production Period of Goryo(高麗) Iron 'Sung(成)' Inscribed Celadon (고려(高麗) 철화(鐵畵) '성(成)' 명청자(銘靑瓷)의 특징(特徵)과 제작시기(製作時期))

  • Han, Sung Uk
    • Korean Journal of Heritage: History & Science
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    • v.41 no.2
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    • pp.61-78
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    • 2008
  • Celadons painted in underglaze iron brown 'Sung(成)' inscription are characteristic celadons excavated only at the No. 7 kiln site located at Sadang-ri(沙堂里), Daegu-myeon(大口面), Gangjin-gun(康津郡), Jeollanamdo(全羅南道), Korea and has inscription in the inner center of the foot by brush. The inscription was marked where it is not easily seen. it can be assumed that since it showed a variety of hand writings, many people were involved in manufacturing these celadons and the 'Sung' inscription was marked after workshop rather than manufacturer. It was also found that quality of glaze, paste, shape, pattern and firing method were same and these were manufactured with the same techniques in the same period. Kinds of these celadons were mainly sets of tablewares including bowl with handle, bowl, plate, cup, bowl with cover and bottle. Raised relief designs using extrusion technic were especially preferred rather than incised designs and inlaid designs. Cases of using inlaid designs were not frequently found compared to incised designs, thus it can be assumed that in this period, inlaid designs were not generally used. Special designs having the meaning of authority or dignity such as chrysanthemum, peony, parrot and lotus plate designs were not found. Foot was molded with 'U' type except some bowls with cover and plates and firing was done after glazing the whole surface of the ceramic with the support of quartzite at 3 to 4 places of inner bottom of foot. Production period of these celadons with 'Sung' inscription can not be confirmed from other excavation sites outside of No. 7 kiln site at Sadang-ri since there are no other excavation sites whose relics bear 'Sung' inscription. Through comparison research with other relics bear the characteristics of these celadons from tombs, temple sites, shipwrecks, production period of these celadons with 'Sung' inscription can be assumed as second quarter of 13th century. And since the quality of these celadons are generally inferior to the top-quality celadons which were supplied to royal familes and high-ranking aristocrats, it can be deducted that these celadons with 'Sung' inscription were supplied to classes lower than royal familes and high-ranking aristocrats. So it is considered that Celadons with 'Sung' inscription have a great significance as a chronological material to complement the blank of the first half of the 13th century because most of celadons with raised relief designs and engraved relief designs were attributed to 12th century, the period of prosperity.

Changes of Yield and Quality in Potato (Solanum tuberosum L.) by Heat Treatment (폭염처리에 의한 감자의 수량성과 품질 변화)

  • Lee, Gyu-Bin;Choi, Jang-Gyu;Park, Young-Eun;Jung, Gun-Ho;Kwon, Do-Hee;Jo, Kwang-Ryong;Cheon, Chung-Gi;Chang, Dong Chil;Jin, Yong-Ik
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.24 no.3
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    • pp.145-154
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    • 2022
  • Due to abnormal weather conditions caused by climate change, natural disasters and damages are gradually increasing around the world. Global climate change as accompanied by warming is projected to exert adverse impact on production of potato, which is known as cool season crop. Even though, role of potato as a food security crop is expected to increase in the future, the climate change impacts on potato and adaption strategies are not sufficiently established. Therefore, this study was conducted to analyze the damage pattern of potatoes due to high temperature treatment and to evaluate the response of cultivars. T he high temperature treatment (35~38℃) induced heat stress by sealing the plastic house in midsummer (July), and the quantity and quality characteristics of potatoes were compared with the control group. T otal yield, marketable yield (>80 g) and the number of tubers per plants decreased when heat treatment was performed, and statistical significance was evident. In the heat treatment, 'Jayoung' cultivar suffered a high heat damage with an 84% reduction in yield of >80 g compared to the control group. However, in Jopung cultivar, the decrease was relatively small at 26%. Tuber physiological disturbances (Secondary growth, Tuber cracking, Malformation) tended to increase in the heat stress. Under heat conditions, the tubers were elongated overall, which means that the marketability of potatoes was lowered. T he tuber firmness and dry matter content tended to decrease significantly in the heat-treated group. T herefore, the yield and quality of tubers were damaged when growing potatoes in heat conditions. T he cultivar with high heat adaptability was 'Jopung'. T his result can be used as basic data for potato growers and breeding of heat-resistant cultivars.

Research on The Utility of Acquisition of Oblique Views of Bilateral Orbit During the Dacryoscintigraphy (눈물길 조영검사 시 양측 안 와 사위 상 획득의 유용성에 대한 연구)

  • Park, Jwa-Woo;Lee, Bum-Hee;Park, Seung-Hwan;Park, Su-Young;Jung, Chan-Wook;Ryu, Hyung-Gi;Kim, Ho-Shin
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.76-81
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    • 2014
  • Purpose: Diversity and the lachrymal duct deformities and the passage inside the nasal cavity except for anterior image such as epiphora happens during the test were able to express more precisely during the dacryoscintigraphy. Also, we thought about the necessity of a method to classify the passage into the naso-lachrymal duct from epiphora. Therefore, we are to find the validity of the method to obtain both oblique views except for anterior views. Materials and Methods: The targets of this research are 78 patients with epiphora due to the blockage at the lachrymal duct from January 2013 to August 2013. Average age was $56.96{\pm}13.36$. By using a micropipette, we dropped 1-2 drops of $^{99m}TcO4^-$ of 3.7 MBq (0.1 mCi) with $10{\mu}L$ of each drop into the inferior conjunctival fold, then we performed dynamic check for 20 minutes with 20 frames of each minute. In case of we checked the passage from both eyes to nasal cavity immediately after the dynamic check, we obtained oblique view immediately. If we didn't see the passage in either side of the orbit, we obtained oblique views of the orbit after checking the frontal film in 40 minutes. The instrument we used was Pin-hole Collimator with Gamma Camera(Siemens Orbiter, Hoffman Estates, IL, USA). Results: Among the 78 patients with dacryoscintigraphy, 35 patients were confirmed with passage into the nasal cavity from the anterior view. Among those 35 patients, 15 patients were confirmed with passage into the nasal cavity on both eyes, and it was able to observe better passage patterns through oblique view with a result of 8 on both eyes, 2 on left eye, and 1 on right eye. 20 patients had passage in left eye or right eye, among those patients 10 patients showed clear passage compared to the anterior view. 13 patients had possible passage, and 30 patients had no proof of motion of the tracer. To sum up, 21 patients (60%) among 35 patients showed clear pattern of passage with additional oblique views compared to anterior view. People responded obtaining oblique views though 5 points scale about the utility of passage identification helps make diagnoses the passage, passage delayed, and blockage of naso-lachrymal duct by showing the well-seen portions from anterior view. Also, when classifying passage to naso-lachrymal duct and flow to the skin, oblique views has higher chance of classification in case of epiphora (anterior:$4.14{\pm}0.3$, oblique:$4.55{\pm}0.4$). Conclusion: It is considered that if you obtain oblique views of the bilateral orbits in addition to anterior view during the dacryoscintigraphy, the ability of diagnose for reading will become higher because you will be able to see the areas that you could not observe from the anterior view so that you can see if it emitted after the naso-lachrymal duct and the flow of epiphora on the skin.

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